Study protocol for the TRUSt trial: a pragmatic randomised controlled trial comparing the standard of care with a transitional pain service for patients at risk of chronic postsurgical pain undergoing surgery

Introduction Patients with either surgery-related or patient-related risk factors are at an increased risk of acute and chronic postsurgical pain (CPSP) and long-term opioid use. To improve recovery, prevent CPSP and decrease opioid use, we need to identify these patients before surgery and provide...

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Main Authors: Markus W. Hollmann, Henning Hermanns, Manouk Admiraal, Carin G.C.L. Wensing, Soe L. Meinsma, Hans C. H. Wartenberg, Martin V. H. Rutten, Vivian M. C. Ward - van der Stam
Format: Article
Language:English
Published: BMJ Publishing Group 2021-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/8/e049676.full
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author Markus W. Hollmann
Henning Hermanns
Manouk Admiraal
Carin G.C.L. Wensing
Soe L. Meinsma
Hans C. H. Wartenberg
Martin V. H. Rutten
Vivian M. C. Ward - van der Stam
author_facet Markus W. Hollmann
Henning Hermanns
Manouk Admiraal
Carin G.C.L. Wensing
Soe L. Meinsma
Hans C. H. Wartenberg
Martin V. H. Rutten
Vivian M. C. Ward - van der Stam
author_sort Markus W. Hollmann
collection DOAJ
description Introduction Patients with either surgery-related or patient-related risk factors are at an increased risk of acute and chronic postsurgical pain (CPSP) and long-term opioid use. To improve recovery, prevent CPSP and decrease opioid use, we need to identify these patients before surgery and provide a multidisciplinary pain management strategy throughout hospital admission and follow-up in the postdischarge period. We hypothesise that a multidisciplinary transitional pain service (TPS) improves quality of recovery and reduce the incidence of CPSP and opioid consumption.Methods and analysis We aim to investigate the effectiveness of implementation of a TPS for patients at risk of developing CPSP. The trial design is a pragmatic, open-label, randomised controlled trial (RCT). After stratification for sex, patients are randomly assigned to the TPS or standard of care (SOC) group. Our primary outcome is the quality of recovery, measured at the morning of the third postoperative day, employing the quality of recovery (QoR)-15 questionnaire. Secondary outcomes are the incidence of CPSP, opioid consumption and patient-reported outcome measures at 3 and 6 months postoperatively. We need to enrol 176 patients to detect a minimal clinical important difference of 8 points on the QoR-15 score.Ethics and dissemination Ethics approval was obtained by the accredited medical research ethics committee of the Academic Medical Center in Amsterdam (2020_211) on 15 October 2020. Protocol version 3.2 was approved on 25 January 2020. The trial is registered with the Netherlands Trial Register, NL9115. The results will be disseminated by open access publication in a peer-reviewed journal.Trial registration number NL9115
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spelling doaj.art-7e96346f0d2b434090046f5bf9c235252022-12-21T19:58:45ZengBMJ Publishing GroupBMJ Open2044-60552021-08-0111810.1136/bmjopen-2021-049676Study protocol for the TRUSt trial: a pragmatic randomised controlled trial comparing the standard of care with a transitional pain service for patients at risk of chronic postsurgical pain undergoing surgeryMarkus W. Hollmann0Henning Hermanns1Manouk Admiraal2Carin G.C.L. Wensing3Soe L. Meinsma4Hans C. H. Wartenberg5Martin V. H. Rutten6Vivian M. C. Ward - van der Stam7Department of Anesthesiology, Amsterdam UMC - Locatie AMC, Amsterdam, The NetherlandsDepartment of Anesthesiology, Amsterdam UMC - Locatie AMC, Amsterdam, The NetherlandsDepartment of Anesthesiology, Amsterdam UMC - Locatie AMC, Amsterdam, The NetherlandsDepartment of Anesthesiology, Amsterdam UMC - Locatie AMC, Amsterdam, The NetherlandsDepartment of Anesthesiology, Amsterdam UMC - Locatie AMC, Amsterdam, The NetherlandsDepartment of Anesthesiology, Amsterdam UMC - Locatie AMC, Amsterdam, The NetherlandsDepartment of Anesthesiology, Amsterdam UMC - Locatie AMC, Amsterdam, The NetherlandsDepartment of Anesthesiology, Amsterdam UMC - Locatie AMC, Amsterdam, The NetherlandsIntroduction Patients with either surgery-related or patient-related risk factors are at an increased risk of acute and chronic postsurgical pain (CPSP) and long-term opioid use. To improve recovery, prevent CPSP and decrease opioid use, we need to identify these patients before surgery and provide a multidisciplinary pain management strategy throughout hospital admission and follow-up in the postdischarge period. We hypothesise that a multidisciplinary transitional pain service (TPS) improves quality of recovery and reduce the incidence of CPSP and opioid consumption.Methods and analysis We aim to investigate the effectiveness of implementation of a TPS for patients at risk of developing CPSP. The trial design is a pragmatic, open-label, randomised controlled trial (RCT). After stratification for sex, patients are randomly assigned to the TPS or standard of care (SOC) group. Our primary outcome is the quality of recovery, measured at the morning of the third postoperative day, employing the quality of recovery (QoR)-15 questionnaire. Secondary outcomes are the incidence of CPSP, opioid consumption and patient-reported outcome measures at 3 and 6 months postoperatively. We need to enrol 176 patients to detect a minimal clinical important difference of 8 points on the QoR-15 score.Ethics and dissemination Ethics approval was obtained by the accredited medical research ethics committee of the Academic Medical Center in Amsterdam (2020_211) on 15 October 2020. Protocol version 3.2 was approved on 25 January 2020. The trial is registered with the Netherlands Trial Register, NL9115. The results will be disseminated by open access publication in a peer-reviewed journal.Trial registration number NL9115https://bmjopen.bmj.com/content/11/8/e049676.full
spellingShingle Markus W. Hollmann
Henning Hermanns
Manouk Admiraal
Carin G.C.L. Wensing
Soe L. Meinsma
Hans C. H. Wartenberg
Martin V. H. Rutten
Vivian M. C. Ward - van der Stam
Study protocol for the TRUSt trial: a pragmatic randomised controlled trial comparing the standard of care with a transitional pain service for patients at risk of chronic postsurgical pain undergoing surgery
BMJ Open
title Study protocol for the TRUSt trial: a pragmatic randomised controlled trial comparing the standard of care with a transitional pain service for patients at risk of chronic postsurgical pain undergoing surgery
title_full Study protocol for the TRUSt trial: a pragmatic randomised controlled trial comparing the standard of care with a transitional pain service for patients at risk of chronic postsurgical pain undergoing surgery
title_fullStr Study protocol for the TRUSt trial: a pragmatic randomised controlled trial comparing the standard of care with a transitional pain service for patients at risk of chronic postsurgical pain undergoing surgery
title_full_unstemmed Study protocol for the TRUSt trial: a pragmatic randomised controlled trial comparing the standard of care with a transitional pain service for patients at risk of chronic postsurgical pain undergoing surgery
title_short Study protocol for the TRUSt trial: a pragmatic randomised controlled trial comparing the standard of care with a transitional pain service for patients at risk of chronic postsurgical pain undergoing surgery
title_sort study protocol for the trust trial a pragmatic randomised controlled trial comparing the standard of care with a transitional pain service for patients at risk of chronic postsurgical pain undergoing surgery
url https://bmjopen.bmj.com/content/11/8/e049676.full
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